Conservative surgery for mitral valve prolapse with regurgitation: clinical follow-up and noninvasive assessment

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Abstract
To evaluate the result of mitral valve repair in pure regurgitation due to mitral valve prolapse with or without chordal rupture, 11 patients were followed noninvasively for 2.0 to 3.5 years and clinically for at least 5 years in a prospective study. The patients were operated upon before ominous signs of left ventricular dysfunction appeared, all patients being in functional class III, with an ejection fraction of at least 0.50 and mean velocity of circumferential fibre shortening above 1.0. There was no operative mortality. No thrombo-embolic episodes occurred during follow-up. Ten of the 11 patients were alive 5 years postoperatively. One patient died 9 months after the initial repair shortly after reoperation for mitral and tricuspid regurgitation. The other patients all showed definite clinical improvement. Confirming the experience of others, the two patients with ruptured chordae to the anterior mitral leaflet and the only patient with a thick anterior mitral leaflet all had moderate mitral regurgitation postoperatively. Complete repair of mitral valve prolapse is feasible and gives a good functional result of long duration. The results of this study support early mitral repair when complete restoration of ventricular size and function is still possible.